Beyond statistics: health inequities in rural and remote communities of Australia – Authors' reply
Authors: Sheikh Mohammed Shariful Islam, Ralph Maddison
Journal: The Lancet Public Health (2023)

We thank Subash Thapa and colleagues for their comments about the representativeness of data on the burden of disease for rural and First Nation communities in our Article.1GBD 2019 Australia CollaboratorsThe burden and trend of diseases and their risk factors in Australia, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019.Lancet Public Health. 2023; 8: e585-e599Summary Full Text Full Text PDF PubMed Scopus (2) Google Scholar In the discussion section of our Article, we highlighted the limitations of the methods of the Global Burden of Disease study, including the absence of data by state-level, territory-level, and population size. We have also highlighted the need to collect and analyse population-level data from rural and remote communities, including disadvantaged populations, to understand the disparities and direct appropriate resources to people most in need. The Australian Institute of Health and Welfare routinely collects and reports data on the national and subnational burden of diseases in Australia, including rural, remote, and First Nation communities, as well as different socioeconomic groups.2Australian Institute of Health WelfareRural and remote health. Australian Institute of Health Welfare, Canberra2023Google Scholar The objective of our Article was to systematically analyse the burden of diseases and risk factors in Australia from 1990 to 2019 and compare how Australia performed against similar socioeconomic countries. However, our Article did not focus on the health inequalities in rural and remote communities in Australia. Providing an appropriate level of health services to people in rural and remote regions and addressing health inequalities remains a challenge in Australia and globally. Although we agree that health authorities should not exclusively rely on national-level data to determine health priorities and funding allocations, health funding in Australia is primarily allocated on the basis of principles of equity and improving health outcomes for all people, including the least advantaged. However, in reality, current funding allocations are aligned with the population size and often not the health needs of specific population groups or locations.3Kirigia DG Beyond needs-based health funding: resource allocation and equity at the state and area health service levels in New South Wales, Australia. University of New South Wales, Sydney2009Google Scholar There is a need for a national, needs-based funding mechanism with an effective resource allocation tool based on robust evidence to guide the distribution of health funds to address the health inequality in Australia.4Wakerman J Humphreys JS "Better health in the bush": why we urgently need a national rural and remote health strategy.Med J Aust. 2019; 210: 202-203Crossref PubMed Scopus (0) Google Scholar We believe that estimates of disease burden and trends in Australia will provide valuable evidence to guide population health policies and health-care priorities and thus aid in formulation resource allocation. SMSI is funded by the National Heart Foundation of Australia (102112) and a National Health and Medical Research Council Emerging Leadership Fellowship (APP1195406) and is voluntary member of the European Heart Failure Association cardiac device committee, Cardiac Society of Australia and New Zealand IT committee, and UN Global Initiative on Artificial Intelligence for Health. RM declares no competing interests.